title: Outcomes of pregnancy in women with congenital heart disease: a single center experience in Korea.
abstract: Pregnancy outcomes in patients with congenital heart disease have not been fully assessed in Korea. Forty-nine pregnancies that occurred in 34 women with congenital heart disease who registered at our hospital between September 1995 and April 2006 were reviewed. Spontaneous abortions occurred in two pregnancies at 6+1 and 7 weeks, and another two underwent elective pregnancy termination. One maternal death in puerperium occurred in a woman with Eisenmenger syndrome. Maternal cardiac complications were noted in 18.4%, pulmonary edema in 16.3%, symptomatic arrhythmia in 6.1%, deterioration of New York Heart Association (NYHA) functional class by >or=2 in 2.0%, and cardiac death in 2.0%. Independent predictors of adverse maternal cardiac events were an NYHA functional class of >or=3 (odds ratio [OR], 20.3), right ventricular dilation (OR, 21.2), and pulmonary hypertension (OR, 21.8). Neonatal complications occurred in 22.4% of pregnancies and included preterm delivery (16.3%), small for gestational age (12.2%), and neonatal death (2.0%). Independent predictors of adverse neonatal events were pulmonary hypertension (OR, 6.8) and NYHA functional class>or=3 (OR, 23.0). Pregnancy in women with congenital heart disease was found to be significantly associated with maternal cardiac and neonatal complications. Pre-pregnancy counseling and multidisciplinary care involving cardiologists and obstetricians are recommended for women with congenital heart disease contemplating pregnancy.
authors.affiliation: Department of Medicine, Sungkyunkwan University School of Medicine, Grown-Up Congenital Heart Disease Clinic, Cardiac and Vascular Center, Samsung Medical Center, Seoul, Korea.
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.forename: Seung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Jun Hyung
authors.initials: JH
authors.lastname: Kim
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Shin
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Cho
authors.forename: Jin-Oh
authors.initials: JO
authors.lastname: Choi
authors.forename: Sang-Chol
authors.initials: SC
authors.lastname: Lee
authors.forename: Ju Ryoung
authors.initials: JR
authors.lastname: Moon
authors.forename: June
authors.initials: J
authors.lastname: Huh
authors.forename: I-Seok
authors.initials: IS
authors.lastname: Kang
authors.forename: Heung Jae
authors.initials: HJ
authors.lastname: Lee
mesh_terms: D000022:Abortion, Spontaneous; D000328:Adult; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D007723:Korea; D015999:Multivariate Analysis; D009774:Obstetrics / Q000379:methods; D016017:Odds Ratio; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000503:physiopathology; D011256:Pregnancy Outcome